Researchers from Mass General Brigham have found that nearly a third of American adults without heart disease, and almost 80% of those who have suffered a heart attack or stroke, have LDL cholesterol levels exceeding the targets set by the new 2026 American cholesterol guidelines. The study, published in JAMA, highlights that around 75% of those without heart disease and elevated LDL levels are not receiving cholesterol-lowering treatment.
Shady Abohashem, a Harvard Medical School instructor, noted the significant gap between current cholesterol levels and the new guidelines, emphasizing that many preventable heart attacks and strokes could be avoided with available medications. The 2026 guidelines by the American College of Cardiology and American Heart Association include a new risk calculator and reduced LDL targets, underscoring the “lower is better” approach for high-risk patients.
Abohashem’s team analyzed data from approximately 2,300 adults, aged 30 to 79, using the National Health and Nutrition Examination Survey from 2021-2023. The guidelines recommend varying LDL levels based on cardiovascular risk, with those at higher risk requiring lower LDL levels. For instance, individuals at low risk are advised to consider treatment at LDL levels of 160 mg/dL or higher, while those with heart disease should aim for below 55 mg/dL.
The research revealed that around one-third of adults without prior cardiovascular events had LDL levels above the new targets, with 76% not on medication. Among high-risk individuals, 83% exceeded the LDL goals, with about half not receiving any treatment. In contrast, 80% of those with heart disease were above the recommended LDL levels, with 62% on medication but not meeting targets, indicating a need for more intensive therapy.
Abohashem emphasized the need for different approaches for different groups: initiating treatment for those without heart disease and intensifying treatment for those already on statins but not meeting goals. Factors contributing to the persistent treatment gap include limited access to new medications and systemic healthcare barriers. The study data were collected before the 2026 guidelines, serving as a baseline to measure future progress.
Abohashem stated, “What we’re measuring here is a starting line, not a verdict,” highlighting the importance of re-evaluating patients against the new targets. The public is encouraged to know their LDL levels and personal targets, and to consult their doctors if uncertain.
Original Source: news.harvard.edu
